# Elevance Health, Inc. (ELV)

Informational only - not investment advice.

CIK: 0001156039
SIC: 6324 Hospital & Medical Service Plans
SIC breadcrumb: [Finance, Insurance, And Real Estate](/division/H/) > [Insurance Carriers](/major-group/63/) > [SIC 6324 Hospital & Medical Service Plans](/industry/6324/)
Latest 10-K filed: 2026-02-06
SEC page: https://www.sec.gov/edgar/browse/?CIK=1156039
Filing source: https://www.sec.gov/Archives/edgar/data/1156039/000115603926000013/elv-20251231.htm

## At a glance

FY2025 · period end 2025-12-31 · filed 2026-02-06 · accession 0001156039-26-000013 · source: https://data.sec.gov/api/xbrl/companyfacts/CIK0001156039.json

| Metric | Value | FY | Provenance |
| --- | ---: | ---: | --- |
| Revenue | 199,125,000,000 USD | 2025 | verified |
| Net income | 5,662,000,000 USD | 2025 | verified |
| Assets | 121,494,000,000 USD | 2025 | verified |
| Free cash flow | 3,174,000,000 USD | 2025 | computed |
| Net margin | 2.84% | 2025 | computed |
| Operating margin | 3.62% | 2025 | computed |
| Revenue YoY | +12.49% | 2025 | computed |
| ROE | 12.90% | 2025 | computed |

Computed values are grepcent-computed from the verified facts above and may differ from ratios the company itself reports. Free cash flow = operating cash flow − capital expenditures. Net margin = net income ÷ revenue. Operating margin = operating income ÷ revenue. Revenue YoY = FY2025 revenue ÷ FY2024 revenue − 1 (consecutive fiscal years only). ROE = net income ÷ period-end stockholders' equity.

Peer groups: [Managed care and health insurers](/compare/managed-care/) · SIC 6324 Hospital & Medical Service Plans

No market price, no rating, no forecast on this site. Not investment advice.

## Peer comparisons including ELV

- Managed care and health insurers: [peer review](/compare/managed-care/) · [market-risk page](/compare/managed-care/risk/)

### Peer percentile fingerprint

| Ratio | ELV | Peer median | Percentile | N |
| --- | ---: | ---: | ---: | ---: |
| Net margin | 2.8% | 1.0% | 100 | 10 |
| Operating margin | 3.6% | 1.3% | 89 | 10 |
| Revenue growth | 12.5% | 12.2% | 56 | 10 |
| FCF margin | 1.6% | 2.2% | 38 | 9 |
| ROE | 12.9% | 5.9% | 89 | 10 |
| ROA | 4.7% | 2.3% | 100 | 10 |
| Liabilities / equity | 1.77 | 2.43 | 22 | 10 |
| Current ratio | 1.54 | 1.50 | 56 | 10 |

Percentile = share of the N covered peers reporting that ratio whose value is lower (ties counted half); computed among grepcent-covered companies in SIC industry 6324 Hospital & Medical Service Plans, not the whole market. A higher percentile means a higher value of the ratio, not a better company. Ratios with fewer than 8 reporting peers are omitted. Latest reported values per company; fiscal periods may differ. Descriptive arithmetic - not a score, rating, or ranking.

## Selected Fundamentals
| Metric | Value | Unit | FY | Filed |
| --- | ---: | --- | ---: | --- |
| Revenue | 199125000000 | USD | 2025 | 2026-02-06 |
| Net income | 5662000000 | USD | 2025 | 2026-02-06 |
| Assets | 121494000000 | USD | 2025 | 2026-02-06 |

## Financials

Annual standardized facts from SEC companyfacts as of latest extracted filing date 2026-02-06. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0001156039.json. Derived margins, ratios, and free cash flow are computed from the extracted annual SEC facts.

| Metric | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
| --- | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: |
| Revenue | 84,863,000,000 | 90,040,000,000 | 92,105,000,000 | 104,213,000,000 | 121,867,000,000 | 138,639,000,000 | 156,595,000,000 | 171,340,000,000 | 177,011,000,000 | 199,125,000,000 |
| Net income | 2,470,000,000 | 3,843,000,000 | 3,750,000,000 | 4,807,000,000 | 4,572,000,000 | 6,158,000,000 | 5,894,000,000 | 5,987,000,000 | 5,980,000,000 | 5,662,000,000 |
| Operating income | 4,801,000,000 | 4,175,000,000 | 5,426,000,000 | 5,999,000,000 | 6,360,000,000 | 7,559,000,000 | 8,283,000,000 | 8,499,000,000 | 7,862,000,000 | 7,199,000,000 |
| Diluted EPS | 9.21 | 14.35 | 14.19 | 18.47 | 17.98 | 24.95 | 24.28 | 25.22 | 25.68 | 25.21 |
| Operating cash flow | 3,270,000,000 | 4,185,000,000 | 3,827,000,000 | 6,061,000,000 | 10,688,000,000 | 8,364,000,000 | 8,399,000,000 | 8,061,000,000 | 5,808,000,000 | 4,290,000,000 |
| Capital expenditures | 584,000,000 | 791,000,000 | 1,208,000,000 | 1,077,000,000 | 1,021,000,000 | 1,087,000,000 | 1,152,000,000 | 1,296,000,000 | 1,256,000,000 | 1,116,000,000 |
| Dividends paid | 684,000,000 | 705,000,000 | 776,000,000 | 818,000,000 | 954,000,000 | 1,104,000,000 | 1,229,000,000 | 1,395,000,000 | 1,508,000,000 | 1,529,000,000 |
| Share buybacks | 0.00 | 1,998,000,000 | 1,685,000,000 | 1,701,000,000 | 2,700,000,000 | 1,900,000,000 | 2,316,000,000 | 2,676,000,000 | 2,900,000,000 | 2,605,000,000 |
| Assets | 65,083,100,000 | 70,540,000,000 | 71,571,000,000 | 77,453,000,000 | 86,615,000,000 | 97,460,000,000 | 102,755,000,000 | 108,928,000,000 | 116,889,000,000 | 121,494,000,000 |
| Liabilities | 39,982,700,000 | 44,037,000,000 | 43,030,000,000 | 45,725,000,000 | 53,416,000,000 | 61,332,000,000 | 66,425,000,000 | 69,523,000,000 | 75,463,000,000 | 77,468,000,000 |
| Stockholders' equity | 25,101,000,000 | 26,503,000,000 | 28,541,000,000 | 31,728,000,000 | 33,199,000,000 | 36,060,000,000 | 36,243,000,000 | 39,306,000,000 | 41,315,000,000 | 43,882,000,000 |
| Cash and cash equivalents | 4,075,000,000 | 3,609,000,000 | 3,934,000,000 | 4,937,000,000 | 5,741,000,000 | 4,880,000,000 | 7,387,000,000 | 6,526,000,000 | 8,288,000,000 | 9,491,000,000 |
| Free cash flow | 2,686,000,000 | 3,394,000,000 | 2,619,000,000 | 4,984,000,000 | 9,667,000,000 | 7,277,000,000 | 7,247,000,000 | 6,765,000,000 | 4,552,000,000 | 3,174,000,000 |

### Ratios

ROE and ROA use period-end equity/assets. Liabilities / equity uses total liabilities divided by stockholders' equity. Current ratio uses current assets divided by current liabilities when both are reported.

| Metric | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
| --- | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: | ---: |
| Net margin | 2.91% | 4.27% | 4.07% | 4.61% | 3.75% | 4.44% | 3.76% | 3.49% | 3.38% | 2.84% |
| Operating margin | 5.66% | 4.64% | 5.89% | 5.76% | 5.22% | 5.45% | 5.29% | 4.96% | 4.44% | 3.62% |
| Return on equity | 9.84% | 14.50% | 13.14% | 15.15% | 13.77% | 17.08% | 16.26% | 15.23% | 14.47% | 12.90% |
| Return on assets | 3.80% | 5.45% | 5.24% | 6.21% | 5.28% | 6.32% | 5.74% | 5.50% | 5.12% | 4.66% |
| Liabilities / equity | 1.59 | 1.66 | 1.51 | 1.44 | 1.61 | 1.70 | 1.83 | 1.77 | 1.83 | 1.77 |
| Current ratio | 1.61 | 1.55 | 1.56 | 1.66 | 1.55 | 1.47 | 1.40 | 1.44 | 1.45 | 1.54 |

## As-reported value updates

4 tracked differences above grepcent's stated thresholds were found between the earliest XBRL-filed value and the value currently on file for the same fiscal period.

Ledger: /company/ELV/revisions/


## Quarterly

Quarterly standardized facts from SEC companyfacts as of latest extracted filing date 2026-07-15. Source: https://data.sec.gov/api/xbrl/companyfacts/CIK0001156039.json.

Flow metrics use discrete quarter-length periods from 10-Q/10-Q/A filings. Q4 revenue and net income are derived only when annual FY and nine-month YTD facts exist for the same fiscal year; derived Q4 values are labeled. EPS Q4 is not derived.

| Quarter | End date | Revenue | Net income | Diluted EPS | Method |
| --- | --- | ---: | ---: | ---: | --- |
| 2022-Q3 | 2022-09-30 |  |  | 6.68 | reported discrete quarter |
| 2023-Q1 | 2023-03-31 |  |  | 8.30 | reported discrete quarter |
| 2023-Q2 | 2023-06-30 |  |  | 7.79 | reported discrete quarter |
| 2023-Q3 | 2023-09-30 | 42,849,000,000 | 1,289,000,000 | 5.45 | reported discrete quarter |
| 2023-Q4 | 2023-12-31 | 42,647,000,000 | 856,000,000 |  | derived Q4 = FY annual - nine-month YTD |
| 2024-Q1 | 2024-03-31 | 42,577,000,000 | 2,246,000,000 | 9.59 | reported discrete quarter |
| 2024-Q2 | 2024-06-30 | 43,886,000,000 | 2,300,000,000 | 9.85 | reported discrete quarter |
| 2024-Q3 | 2024-09-30 | 45,106,000,000 | 1,016,000,000 | 4.36 | reported discrete quarter |
| 2024-Q4 | 2024-12-31 | 45,442,000,000 | 418,000,000 |  | derived Q4 = FY annual - nine-month YTD |
| 2025-Q1 | 2025-03-31 | 48,891,000,000 | 2,183,000,000 | 9.61 | reported discrete quarter |
| 2025-Q2 | 2025-06-30 | 49,776,000,000 | 1,743,000,000 | 7.72 | reported discrete quarter |
| 2025-Q3 | 2025-09-30 | 50,711,000,000 | 1,189,000,000 | 5.32 | reported discrete quarter |
| 2025-Q4 | 2025-12-31 | 49,747,000,000 | 547,000,000 |  | derived Q4 = FY annual - nine-month YTD |
| 2026-Q1 | 2026-03-31 | 50,181,000,000 | 1,764,000,000 | 8.00 | reported discrete quarter |
| 2026-Q2 | 2026-06-30 | 50,474,000,000 | 1,463,000,000 | 6.71 | reported discrete quarter |

## Filed narrative (10-K & 10-Q)

## Business

Verbatim Item 1 Business section from ELV's latest 10-K: [/company/ELV/business/](/company/ELV/business/).

## Risk Factors

Verbatim Item 1A Risk Factors from ELV's latest 10-K: [/company/ELV/risk-factors/](/company/ELV/risk-factors/).

## Latest quarter (10-Q)

Latest 10-Q source: https://www.sec.gov/Archives/edgar/data/1156039/000115603926000060/elv-20260630.htm

Extracted from a substantive MD&A body after the formal Item 2 span was a TOC or reference stub.
Confidence: high
Filing date: 2026-07-15
Report date: 2026-06-30

Overview

Elevance Health is a health company with the purpose of improving the health of humanity. We are one of the largest health insurers in the United States in terms of medical membership, serving approximately 44.9 million medical members through our affiliated health plans as of June 30, 2026. We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross and Anthem Blue Cross and Blue Shield. We also conduct business through arrangements with other BCBS licensees, as well as other strategic partners. In addition, we serve members in numerous states as Wellpoint, Carelon, MMM and/or Simply Healthcare. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries. Through various subsidiaries, we also offer pharmacy services through our CarelonRx business, and other healthcare related services as Carelon Services.

Our portfolio consists of the following core go-to-market brands:

•Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents our Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed Medicare, Medicaid, and commercial Health Benefit plans;

•Wellpoint — represents our Wellpoint branded Medicare, Medicaid and commercial Health Benefit plans and other non-BCBSA brands; and

•Carelon — represents our healthcare related services and capabilities, including our CarelonRx and Carelon Services businesses.

We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other (our businesses that do not individually meet the quantitative thresholds for an operating segment, as well as corporate expenses not allocated to our other reportable segments). For additional information, see Note 13, “Segment Information,” of the Notes to Consolidated Financial Statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

For additional information about our organization, see Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” included in our 2025 Annual Report on Form 10-K.

-35-

Business Trends

Medical Cost Trends: Our medical cost trends are primarily driven by changes in the utilization of services across all provider types and the unit cost of these services. We work to mitigate these trends through various medical management programs such as care and condition management, program integrity and specialty pharmacy management and utilization management, as well as benefit design changes. There are many drivers of medical cost trends that can cause variance from our estimates, such as changes in the level and mix of services utilized, regulatory changes, aging of the population, health status and other demographic characteristics of our members, epidemics, pandemics, advances in medical technology, new high-cost prescription drugs, including increased utilization of specialty pharmaceuticals, new indications of existing prescription drugs, provider contracting inflation, labor costs and healthcare fraud, waste and abuse.

Membership shifts from Medicaid into our Individual ACA (as defined below) business following the redetermination process that began in April 2023, together with lower membership effectuation rates, particularly in geographies with high concentrations of highly subsidized members, have driven a market-wide increase in morbidity, resulting in elevated medical cost trends. Medicaid cost trends remain elevated due to higher population acuity and increased utilization of services. In response, we are working on program improvements in partnership with the states, strengthening care and provider network management, optimizing our clinical strategy to improve effectiveness and enhancing payment integrity to manage costs.

Pricing Trends: We strive to price our health benefit products consistent with anticipated underlying medical cost trends. We frequently make adjustments to respond to legislative and regulatory changes as well as pricing and other actions taken by existing competitors and new market entrants. Revenues from the Medicare and Medicaid programs are dependent, in whole or in part, upon annual funding from the federal government and/or applicable state governments. Product pricing remains competitive. Pricing of the Medicare and Medicaid programs may not adequately reflect current underlying healthcare cost trends given the timing lag between when pricing is established and the start of the applicable contract, which could adversely affect our financial results.

If the approvals of any annual premium rate changes by contracted government agencies are delayed, we are required to defer the recognition of any premium rate increases to the period in which the premium rates become final. The impact of this deferral can be significant in the period in which the increased premium rates are first recognized depending on the magnitude of the premium rate increase, the number of members to which it applies and the length of the delay between the effective date of the rate increase and the final contract date. Premium rate decreases are recognized in the period the change in premium rate becomes effective and the change in the rate is known, which may be prior to the period in which the contract amendment affecting the rate is finalized.

Affordable Care Act: We continue to participate in the Individual state- or federally-facilitated marketplaces (the “Public Exchange”) in nearly all of our Anthem Blue Cross and Anthem Blue Cross and Blue Shield service areas. In 2025, we expanded our operations into select service areas in Florida through our Simply Healthcare brand, and Maryland and Texas through our Wellpoint brand. In 2026, we expanded into Washington through our Wellpoint brand. Going forward, we expect the Public Exchange to be influenced by policy and regulatory changes, particularly around federal subsidies, compliance requirements, and market stability.

CarelonRx: CarelonRx markets and offers pharmacy services to our affiliated health plan customers throughout the country and to customers outside of the health plans we own. Our comprehensive pharmacy services portfolio includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services, as well as infusion services and injectable therapies.

CarelonRx delegates certain core pharmacy services to CaremarkPCS Health, L.L.C., which is a subsidiary of CVS Health Corporation (“CVS”), pursuant to an agreement (the “CVS Agreement”) with the current contractual term extending through December 31, 2027. We can elect to have CVS continue to provide services to us for a three-year extension period on the same terms and conditions as in the current CVS Agreement in the event of a termination or non-renewal by either party.

For additional discussion regarding business trends, see Part I, Item 1, “Business” included in our 2025 Annual Report on Form 10-K.

-36-

Regulatory Trends and Uncertainties

The federal budget reconciliation legislation, known as the One Big Beautiful Bill Act (the “OBBBA”) was signed into law on July 4, 2025. The OBBBA includes provisions that could impact our business and operations including: requiring more frequent Medicaid reverifications for beneficiaries receiving coverage under a state’s Medicaid expansion program implemented pursuant to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”); and imposing work or community engagement requirements on certain adults in the ACA Medicaid expansion population. The OBBBA also makes changes to federal requirements regarding Medicaid state directed payments and provider taxes, including taxes on managed care organizations; delays implementation of Medicaid final regulations on certain eligibility and enrollment provisions; reduces the allowable home equity asset threshold for individuals seeking eligibility for long-term care under Medicaid; establishes a new Rural Health Transformation program; eliminates the repayment limit for excess advanced Premium Tax Credits (“PTCs”) under the ACA; modifies the rules regarding Health Savings Account (“HSA”) eligible plans under the ACA; and makes permanent an extension of the safe harbor first established under the Coronavirus Aid, Relief, and Economic Security Act, allowing pre-deductible coverage of telehealth services for HSA eligible high-deductible health plans; among other provisions.

Additional federal and state guidance is being issued to implement these OBBBA provisions. Implementation dates vary, with many provisions impacting commercial plans effective January 1, 2026, and many Medicaid-related provisions effective in 2027 and 2028. States may choose to implement certain Medicaid provisions as early as 2026.

In May 2026, the U.S. Department of Health and Human Services, Labor, and the Treasury (collectively, the “Tri-Agencies”) issued final regulations updating the federal Independent Dispute Resolution (“IDR”) process used to determine compensation to be paid by health plans to out-of-network providers in certain scenarios under the No Surprises Act. The regulations are primarily procedural in nature and address the operations and administration of the IDR process. Additional regulatory guidance or rulemakings are possible, and changes resulting from any such guidance or rulemakings, as well as current and potential litigation, arbitration proceedings, and government audits related to the IDR and No Surprises Act, could have an adverse effect on our business, cash flows, results of operations and financial condition.

In February 2026, Congress passed the Consolidated Appropriations Act of 2026, which includes pharmacy benefit manager reforms requiring pharmacy benefit managers to remit all rebates, fees (other than bona fide service fees), and other remuneration received from entities such as manufacturers and group purchasing organizations to commercial plan sponsors, and to provide detailed commercial claims reporting, effective 30 months after enactment. The legislation also imposes extensive reporting requirements and delinks pharmacy benefit manager compensation in Medicare Part D by prohibiting pharmacy benefit managers from receiving remuneration related to Part D drugs in any form other than bona fide service fees that cannot be based on a drug’s price, effective in 2028. There continues to be the potential that similar or additional legislation may be adopted at the state or federal level.

In addition, in June 2025, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Marketplace Integrity and Affordability Regulation, which modifies the Public Exchange open enrollment period beginning in plan year 2027 and eligibility for PTCs, among other requirements. In September 2025, a federal court delayed the effective dates for several provisions of the Marketplace Integrity and Affordability Regulation pending the resolution of ongoing litigation challenging the legality of those provisions. Also, in September 2025, CMS issued guidance modifying eligibility requirements for ACA catastroph

[Excerpt truncated for page length; source filing is linked above.]

## Latest 10-K MD&A (excerpt)

Latest 10-K Item 7 source: https://www.sec.gov/Archives/edgar/data/1156039/000115603926000013/elv-20251231.htm
Complete FY 2025 MD&A: /company/ELV/mda/fy2025/

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Published MD&A gate trimmed front/tail over-capture.
Confidence: high
Filing date: 2026-02-06
Report date: 2025-12-31

ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

 (In Millions, Except Per Share Data or as Otherwise Stated Herein)

This Management's Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) should be read in conjunction with the accompanying audited consolidated financial statements and notes, included in Part II, Item 8 of this Annual Report on Form 10-K. References to the terms “we,” “our,” “us,” “Elevance Health” or the “Company” used throughout this MD&A refer to Elevance Health, Inc., an Indiana corporation, and, unless the context otherwise requires, its direct and indirect subsidiaries. References to the “states” include the District of Columbia and Puerto Rico, unless the context otherwise requires.

This MD&A generally discusses 2025 and 2024 items and year-over-year comparisons between 2025 and 2024. A detailed discussion of 2023 items and year-over-year comparisons between 2024 and 2023 that are not included in this Annual Report on Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 included in our Annual Report on Form 10-K for the year ended December 31, 2024.

Overview

Elevance Health is a health company with the purpose of improving the health of humanity. We are one of the largest health insurers in the United States in terms of medical membership, serving approximately 45.2 million medical members through our affiliated health plans as of December 31, 2025. We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross and Anthem Blue Cross and Blue Shield. We also conduct business through arrangements with other BCBS licensees, as well as other strategic partners. In addition, we serve members in numerous states as Wellpoint, Carelon, MMM and/or Simply Healthcare. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries. Through various subsidiaries, we also offer pharmacy services through our CarelonRx business, and other healthcare related services as Carelon Services.

Our portfolio consists of the following core go-to-market brands:

•Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents our Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed Medicare, Medicaid, and commercial Health Benefit plans;

•Wellpoint — represents our Wellpoint branded Medicare, Medicaid and commercial Health Benefit plans and other non-BCBSA brands; and

•Carelon — represents our healthcare related services and capabilities, including our CarelonRx and Carelon Services businesses.

We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other (our businesses that do not individually meet the quantitative thresholds for an operating segment, as well as corporate expenses not allocated to our other reportable segments).

Our results of operations discussed throughout this MD&A are determined in accordance with generally accepted accounting principles (“GAAP”). We also calculate operating gain and operating margin to further aid investors in understanding and analyzing our core operating results. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. Operating margin is calculated as operating gain divided by operating revenue. Our definition of operating gain and operating margin may not be comparable to similarly titled measures reported by other companies. We use these measures as a basis for evaluating segment performance, allocating resources, forecasting future operating periods and setting incentive compensation targets. This information is not intended to be considered in isolation or as a substitute for income before income tax expense, net income or fully-diluted shareholders’ earnings per share

-44-

(“EPS”) prepared in accordance with GAAP. For additional details on operating gain, see our “Reportable Segments Results of Operations” discussion included in this MD&A. For a reconciliation of reportable segment operating revenue to the amounts of total revenue included in the consolidated statements of income and a reconciliation of reportable segment operating gain to income before income tax expense, see Note 20, “Segment Information,” of the Notes to Consolidated Financial Statements included in Part II, Item 8 of this Annual Report on Form 10-K.

Our operating revenue consists of premiums, product revenue, and service fees. Premium revenue is generated from risk-based contracts where we indemnify our policyholders against costs for covered health benefits. Product revenue represents services performed by CarelonRx for unaffiliated pharmacy customers and includes ingredient costs (net of any rebates or discounts), including co-payments made by or on behalf of the customer, and service fees. Unaffiliated pharmacy customers include our fee-based employer groups that contract with CarelonRx for pharmacy services and external customers outside of the health plans we own. Service fees are generated from our fee-based customers for the processing of transactions or network discount savings realized, revenues from our Medicare processing business and revenues from other health-related businesses, including care management programs and miscellaneous other income.

Our benefit expense primarily includes costs of care for health services consumed by our risk-based members, such as outpatient care, inpatient hospital care, professional services (primarily physician care) and pharmacy benefit costs. All four components are affected both by unit costs and utilization rates. Unit costs include the cost of outpatient medical procedures per visit, inpatient hospital care per admission, physician fees per office visit and prescription drug prices. Utilization rates represent the volume of consumption of health services and prescription drugs, and typically vary with the age and health status of our members and their social and lifestyle choices, along with clinical protocols and medical practice patterns in each of our markets. A portion of benefit expense recognized in each reporting period consists of actuarial estimates of claims incurred but not yet paid by us. Any changes in these estimates are recorded in the period the need for such an adjustment arises. While we offer a diversified mix of managed care products and services through our managed care plans, our aggregate cost of care can fluctuate based on a change in the overall mix of these products and services. Our managed care plans include: Preferred Provider Organizations; Health Maintenance Organizations; Point-of-Service plans; Traditional Indemnity plans and other hybrid plans, including Consumer-Driven Health Plans; and hospital only and limited benefit products.

We classify certain quality improvement costs as benefit expense. Quality improvement activities are those designed to improve member health outcomes, prevent hospital readmissions and improve patient safety. They also include expenses for wellness and health promotion provided to our members. These quality improvement costs may be comprised of expenses incurred for: (i) medical management, including care coordination and case management; (ii) health and wellness, including disease management services for such conditions as diabetes, high-risk pregnancies, congestive heart failure and asthma management and wellness initiatives like weight-loss programs and smoking cessation treatments; and (iii) clinical health policy, such as identification and use of best clinical practices to avoid harm, identifying clinical errors and safety concerns, and identifying potential adverse drug interactions.

Our cost of products sold represents the cost of pharmaceuticals dispensed by CarelonRx for our unaffiliated pharmacy customers (net of rebates or discounts), including any co-payments made by or on behalf of the customer, per-claim administrative fees for prescription fulfillment and certain direct costs related to sales and administration of customer contracts.

Our operating expenses consist of fixed and variable costs. Examples of fixed costs are depreciation, amortization and certain facilities expenses. Certain variable costs, such as premium taxes, vary directly with premium volume. Commission expense generally varies with premium or membership volume. Other variable costs, such as salaries and benefits, do not vary directly with changes in premium but are more aligned with changes in membership or services provided to our customers. The acquisition or loss of a significant block of business would likely impact staffing levels and, thus, associated compensation expense. Other variable costs include professional and consulting expenses and advertising. Other factors can impact our administrative cost structure, including systems efficiencies, inflation and changes in productivity.

Our results of operations depend in large part on our ability to accurately predict and effectively manage healthcare costs through effective contracting with providers of care to our members, product pricing, medical management and health and wellness programs, including service coordination and case management for addressing complex and specialized healthcare needs, innovative product design and our ability to maintain or achieve improvement in our Centers for Medicare & Medicaid

-45-

Services (“CMS”) Star Ratings. Several economic factors related to healthcare costs, such as regulatory mandates of coverage as well as direct-to-consumer advertising by providers and pharmaceutical companies, have a direct impact on the volume of care consumed by our members. The potential effect of escalating healthcare costs, any changes in our ability to negotiate competitive rates with our providers and any regulatory or market-driven restrictions on our ability to obtain adequate premium rates to offset overall inflation in healthcare costs, including increases in unit costs and utilization rates resulting from the aging of the population and other demographics, the impact of epidemics and pandemics, as well as advances in medical technology and pharmaceuticals, may impose further risks to our ability to profitably underwrite our business and may have a material adverse impact on our results of operations.

We intend to expand through a combination of organic growth, strategic acquisitions and efficient use of capital in both existing and new markets. Our growth strategy is designed to enable us to take advantage of additional economies of scale, as well as provide us access to new and evolving technologies and products. In addition, we believe geographic and product diversity reduces our exposure to local or regional regulatory, economic and competitive pressures and provides us with increased opportunities for growth. We market and offer pharmacy services through CarelonRx and other subsidiaries, and we expect CarelonRx to continue to improve our ability to integrate pharmacy benefits within our medical and specialty platform. In all other markets, we intend to maintain our position by delivering excellent service, offering competitively priced products, providing access to high-quality provider networks and effectively

[Excerpt truncated for page length; the complete text is on the linked full-MD&A page.]

Read the full FY 2025 MD&A: /company/ELV/mda/fy2025/
All MD&A years: /company/ELV/mda/


## MD&A history

Prior-year 10-K MD&A spans are extracted from SEC filings with the same bounded parser used for the latest filing. Each year's full verbatim text is on its own sub-page.

- [FY 2024 MD&A](/company/ELV/mda/fy2024/): filed 2025-02-20; accession 0001156039-25-000010 (https://www.sec.gov/Archives/edgar/data/1156039/000115603925000010/elv-20241231.htm)
- [FY 2023 MD&A](/company/ELV/mda/fy2023/): filed 2024-02-21; accession 0001156039-24-000015 (https://www.sec.gov/Archives/edgar/data/1156039/000115603924000015/elv-20231231.htm)
- [FY 2022 MD&A](/company/ELV/mda/fy2022/): filed 2023-02-15; accession 0001156039-23-000007 (https://www.sec.gov/Archives/edgar/data/1156039/000115603923000007/elv-20221231.htm)
- [FY 2021 MD&A](/company/ELV/mda/fy2021/): filed 2022-02-16; accession 0001156039-22-000009 (https://www.sec.gov/Archives/edgar/data/1156039/000115603922000009/antm-20211231.htm)




## Macro cross-references

Indicators mapped to this company's SIC classification (industry 6324 Hospital & Medical Service Plans) by grepcent's deterministic macro-sector crosswalk. A navigational mapping, not a statistical or causal claim.

- [FEDFUNDS](/indicator/FEDFUNDS/): Federal Funds Effective Rate
- [DGS10](/indicator/DGS10/): Market Yield on U.S. Treasury Securities at 10-Year Constant Maturity
- [PCEPI](/indicator/PCEPI/): Personal Consumption Expenditures: Chain-type Price Index

Macro-to-micro threads including this sector: [Money & trade](/thread/money-trade/), [Government finances](/thread/government-finances/), [Sector employment](/thread/sector-employment/).

All macro indicators: /indicators/


## For LLMs & downloads

Markdown twin: /company/ELV.md · JSON record: /company/ELV.json · verified financials: /company/ELV/financials.json / /company/ELV/financials.csv · machine TOC for the whole site: /llms.txt